The Rate of Conversion based on the level of the trainee surgeon

Bhavna Gami, BScHonsMScMBBS, Kumran Qurashi, MD

Ealing Hospital, London UK

Introduction

Laparoscopic surgery is known to be advantageous over open surgery; however, the effectiveness of the approach depends on the conversion rate. The aim of our audit was to find out whether the rate of conversion is based on the level of training by the surgeon.

Method

Admissions for gallstone pancreatitis and acute cholecystits between January 2008 and August 2009 were reviewed. Conversion rates were noted for each procedure, previous admissions and length of follow-up.

Results

70 (male=13, female=57) patient’s notes were reviewed who were coded for laparoscopic plus or minus open cholecystectomy. 70 patients were included in the study that had acute or chronic cholecystitis with subsequent laparoscopic cholecystectomy. The conversion rate to open cholecystectomy was 0% between 8 surgeons of various grades from trainee up to consultant.

Conclusion

Our audit is the first to investigate the rate of conversion based on the level of experience of the surgeon. We have found that other parameters may be involved in conversion rates rather than the surgeons’ laparoscopic experience. Improved laparoscopic training programmes for surgeons have been implemented in the UK and this will hopefully maintain the reduced conversion rates.